Hand, Foot, and Mouth Disease in Adult Males

Diagnostic Approach

• Ultrasound with Doppler is the first-line imaging for acute scrotal pain and can help differentiate between various causes, as recommended by the American College of Radiology 1

Differential Diagnosis

• Epididymitis/epididymo-orchitis is the most common cause of testicular pain in adults, according to the American College of Radiology 2, 1
• Testicular torsion is a surgical emergency requiring intervention within 6-8 hours, as stated by the American College of Radiology 3
• Torsion of testicular appendage should be considered in the differential diagnosis, as noted by the American College of Radiology 1

Management Considerations

• For suspected viral epididymo-orchitis due to HFMD, conservative management with serial ultrasounds and bed rest, scrotal elevation, and analgesics until inflammation subsides is recommended by the Centers for Disease Control and Prevention 4, 5

Important Clinical Pearls

• Failure to improve within 3 days requires reevaluation of both the diagnosis and therapy, as recommended by the Centers for Disease Control and Prevention 4, 5